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STUDENT HEALTH SERVICES P. O. Box 10174 Baton Rouge, Louisiana 70813-2021 (225) 771-4770 Baranco-Hill Health Center Helen Barron Drive FAX (225) 771-6225 IMMUNIZATION WAIVER ADDENDUM Name: SS# xxx-xx-
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The immunization waiver addendum is a document that allows individuals to request an exemption from immunization requirements for specific reasons, such as medical or religious beliefs.
Individuals who wish to be exempt from immunization requirements are required to file the immunization waiver addendum.
To fill out the immunization waiver addendum, individuals must provide their personal information, reason for exemption, and any supporting documentation.
The purpose of the immunization waiver addendum is to provide individuals with a legal instrument to request an exemption from immunization requirements.
The immunization waiver addendum typically requires individuals to report their full name, contact information, reason for exemption, and any supporting documentation.
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